Update on Brain Tumors: New Developments in Neuro‐oncologic Diagnosis and Treatment, and Impact on Rehabilitation Strategies

Abstract

Brain tumors can be a source of functional impairment to patients due to neurologic sequelae associated with the tumor itself as well as treatment side effects. As a result, many of these patients may require rehabilitation services. Surgery, chemotherapy, and radiation therapy have been longstanding, primary treatment modalities in the management of brain tumors, though these treatments continue to evolve given new developments in research and technology. A better understanding of the diagnostic workup and current treatment standards helps the physiatrist and rehabilitation team identify rehabilitation services needed, recognize potential side-effects from anticipated or concurrent treatments, and coordinate care with referral sources. The purpose of this article is to review these new advances in diagnosis and treatment of patients with brain tumors, as well as discuss the rehabilitation implications for this population, including factors such as rehabilitation approach, timing of concomitant treatment, cost management, and coordination of care.

A Comparison of Functional Outcomes between Patients Admitted to Inpatient Rehabilitation after Initial Diagnosis Versus Recurrence of Glioblastoma Multiforme

“…This study did not evaluate the cost‐effectiveness of rehabilitation of brain tumor patients, which will be important to analyze in future studies. In admitting individuals with brain tumors to rehabilitation hospitals, health care institutions will have to consider the cost of a higher rate of transfer to the acute care hospitalizations as well as the need for ongoing oncology services during acute rehabilitation admission necessitating hospital transportation . However, use of telehealth in the IRF setting could negate this additional expense of attending oncology appointments in stand‐alone IRFs .…”

A review on nutraceuticals: A healthy way to treat brain cancer

“…It aids in the differentiation of Tumors, radiation necrosis, and normal brain. The combination of CT and PET scans reveals the anatomy (from the CT scan) and functions (from the PET scan) of the brain [10,30,31].…”

Recovery in glioblastoma multiforme during inpatient rehabilitation is equivalent in first versus repeat resection: A 10‐year retrospective analysis

“…Neurological and musculoskeletal impairments resulting from the tumor itself, or from radiation therapy, chemotherapy, or surgery, are quite amenable to rehabilitation management and can have a significant and lasting positive impact on function and quality of life 2‐4 . With an estimated 17 million cancer survivors as of early 2019, 5 there can be little question that the future role of rehabilitation medicine in the care of oncology patients will only expand 6 . Among the various treatment settings, the best evidence is for inpatient rehabilitation with demonstrable improvement in function in a number of cancer diagnoses, 7‐11 even in the presence of metastatic disease 12 …”